background The weaknesses inherent in rom-data in mental health care are largely ignored in Dutch discussions about the pros and cons of rom.
aim To promote awareness among users and potential users of rom with regard to the limitations of rom data in mental health care.
method We present a discussion of three types of measurement problems connected with the use of rom data in mental health care: (a) arbitrary calculation rules for identifying changes that are reliable and of clinical significance, (b) arbitrary metrics and constructs and (c) forced objectivation of subjective information.
results rom measurements are unreliable for use in mental health care because they lack a stable basis. The problems with these measurements are both psychometric and substantive.
conclusion Anyone using or planning to use rom measurements in mental health care should be aware of fundamental measurement problems associated with rom.